Emotional Factors and Crohn’s

Written by Pat Katzmann
| Published on March 4, 2012Medically Reviewed by George Krucik, MD

Crohn's disease got you down? Learn more about emotional health, including the five stages of grief and how to deal with Crohn’s disease.

When
you live with Crohn’s disease, your digestive system becomes the center of your
world. Every plan is subject to the dictatorial nature of your body’s chronic
condition.

When Crohn’s is active and you’re experiencing flare-ups, your
independence may be compromised, possibly limiting your mobility and creating a
variety of issues with family, friends, and co-workers.

Five Stages of Grief

It’s not uncommon for people diagnosed with a chronic condition to
experience a period of grief, as the condition will have a profound impact on
the rest of their lives. Elizabeth Kubler-Ross, a renowned psychiatrist,
proposed five stages of grief as a model for the process of adjusting to death,
which can also apply to emotional trauma, such as a Crohn’s diagnosis.

The five stages of grief include:

Denial: Unless Crohn’s runs in
your family, your Crohn’s diagnosis may come as a surprise, which may lead you
to reject it—especially if you’ve been leading a healthy, active life.
Adolescents may experience denial because the disease will force them revert
back to earlier, childhood levels of dependency on their parents, just as they’re
starting to mature.

Anger: Understandably, having
to restrict your way of life to accommodate a new reality based on chronic
illness can elicit powerful negative feelings. You may be angry with yourself,
your loved ones, and others who don’t have Crohn’s. Because you can’t reverse
your symptoms or cure your disease, you may feel anger towards the diagnosis
itself.

Bargaining: Making the transition
from your old way of life to living with Crohn’s is a challenging process, and
you may be tempted to make compromises that won’t serve your new health
requirements—such as continuing to eat foods that cause flare-ups. You may
think you can redress the balance in other ways, but it’s unlikely.

Depression: There are many facets of
Crohn’s disease that can cause complications—inability to control your bowels,
frequent absences from work, depending on others, and more. These, along with
unexpected flare-ups, can make you uncertain about your future and lead to
isolation and even a loss of confidence, which can lead to depression.

Acceptance: Arriving at this last
stage is necessary for anyone adjusting to living with Crohn’s, as it signals
the detachment from negative emotions. You’ve learned that you don’t have to
let Crohn’s define you.

Navigating Your Emotions

There is no causal relationship between emotions and Crohn’s disease;
however, sufferers who have negative emotional reactions to a diagnosis may
take longer to find effective treatment.

Adolescents are at a particular
risk for encountering difficulty in adapting to a chronic condition. Due to
their inexperience in dealing with the ups and downs of everyday life, they
haven’t yet developed good coping skills.

Coping mechanisms differ from person to person. An optimistic attitude—knowing that many effective
treatments are available—is helpful. Some patients respond to
Crohn’s symptoms with acceptance, while others become upset to the point of
worsening their flare-ups due to stress.

Crohn’s patients who see themselves as a burden on their family may
irrationally blame themselves for somehow attracting the disease. Crohn’s patients can thrive if they accept their
condition and find practical ways to adjust to their reality and take their
symptoms in stride. Here are some ways to take charge:

Prepare for
Eventualities

Always carry a survival kit with
your prescription medications, over-the-counter antidiarrheal medication,
toilet paper, moist wipes, an extra pair of underwear, and a change of clothes.
Do some research if you’ll be away from your home or your workplace to map the
location of public restrooms beforehand.

Get Support

Enlist family members and trusted
friends to provide assistance and offer reality checks as needed.Maintain regular contact with your
doctor, and consider talking to a therapist.Psychotherapy
could help your perspective and avoid unwarranted guilt trips. Help is also available online from the Crohn’s
& Colitis Community, which offers forums, access to members’
personal stories, a panel of experts, downloadable tools that track medical
treatments and daily food intake, plus a wealth of other useful resources,
including chapters you can join: www.ccfacommunity.org.

Empower Yourself

Read everything you can
about Crohn’s. The better you’re able to grasp how the disease affects your
body and mind, the better equipped you’ll be to handle it. Take notice of which
foods trigger flare-ups, and which actions soothe them. This can reassure you
about how much control you have over your condition.

Exercise is a powerful
tool against any condition, so don’t skimp on it, as you’re exercising to
improve your Crohn’s symptoms. If you’re feeling down about your disease, exercise
is also one of the easiest ways to elevate your mood.

Even if the course of your
disease is running smoothly, don’t shy away from learning about what measures
to take if and when it worsens, such as surgery. Knowing what you may have to
face down the line can dispel fearful thinking and help you feel in control of your
ongoing symptoms and your reactions to them. If emotions continue to overwhelm
you, consult with your doctor about other measures, such as anti-anxiety or
anti-depressant medications.

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